Skipping the last chemotherapy cycle

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Dear OncoLink "Ask The Experts," I have breast cancer and am receiving adjuvant chemotherapy. I have been through 5 cycles and feel that I simply cannot take the last one. I am following up with radiation. There is no data on 5 vs.6 cycles. Anything enlightening you might be able to add?

Barbara Campling, MD, Medical Oncologist at the Abramson Cancer Center of the University of Pennsylvania, responds:

I will answer with the assumption that you are correct that you are indeed receiving "adjuvant" chemotherapy, which is being given to decrease the chance of the cancer recurring. You sound
very definite that you are not able to complete your sixth and final cycle of chemotherapy treatment. You are correct that there are no randomized data comparing the effectiveness of 5 vs 6 cycles of chemotherapy. We do know that patients that make it through the full course of chemotherapy may do a little better overall. On the other hand, in many cancers, including breast cancer, the initial chemotherapy treatments are the most beneficial. You have done well to make it through 5 cycles of chemotherapy. You should not feel that you have failed because you have not had the final chemotherapy treatment. Now that the therapy is finished, you will gradually recover from the side effects of treatment and get back to feeling well again. Radiation therapy for breast cancer is generally very well tolerated.